News
Prior Authorization Updates Effective July 1, 2025
Fecha: 29/04/25
Effective July 1, 2025, the following codes will require prior authorization to be submitted to Ambetter of Illinois.
Code | Services |
31276 | Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue from frontal sinus, when performed |
31296 | Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal sinus ostium |
The following codes will no longer require prior authorization to be submitted.
Code | Services |
81257 | HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, Mediterranean, alpha3.7, alpha4.2, alpha20.5, Constant Spring) |
If you have questions, please contact Ambetter Provider Services at 855-745-5507, Monday through Friday, from 8:00 a.m. to 8:00 p.m.